Endocrinology, Diabetes and Metabolism最新文献

{"title":"Effects of SGLT-2 Inhibitors on Plasma Concentrations and Renal Clearance of the Risk Marker Trimethylamine-N-Oxide in Patients With Type-2 Diabetes","authors":"Katja B. Zimmer, Arne Gessner, Dennis Kannenkeril, Agnes Bosch, Armin Ströbel, Roland E. Schmieder, Renke Maas","doi":"10.1002/edm2.70318","DOIUrl":"https://doi.org/10.1002/edm2.70318","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have become a key drug class in the treatment of Type 2 diabetes (T2D) due to their effectiveness in blood sugar control, but also for many other clinical indications because of beneficial effects on cardiovascular diseases and mortality. Therefore, the findings of a secondary analysis of the recent EMMY trial, in which acute myocardial infarction patients treated with empagliflozin had higher trimethylamine-N-oxide (TMAO) serum levels compared to placebo, were unexpected, as high TMAO concentrations in blood have previously been linked to adverse cardiovascular and mortality outcomes. In light of this, the aim of our study was to explore the effects of the SGLT-2 inhibitors empagliflozin and dapagliflozin on plasma concentrations and renal clearance (Cl<sub>R</sub>) in a T2D patient setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Plasma and 24-h urine samples from two prospective, randomised, placebo-controlled, double-blind, cross-over trials with T2D patients (empagliflozin <i>N</i> = 69, NCT02471963; dapagliflozin <i>N</i> = 54, NCT02383238), taken at baseline and after each treatment with either SGLT-2 inhibitor or placebo, were measured for TMAO via LC–MS/MS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After treatment with an SGLT-2 inhibitor, in the total of 123 patients, TMAO plasma levels were 11.5% higher compared to placebo (<i>p</i> = 0.006) and Cl<sub>R</sub> of TMAO was reduced by 10.3% (<i>p</i> = 0.048) without any relevant change in its urinary excretion (<i>p</i> = 0.521). In the dapagliflozin trial, TMAO plasma concentration was 23.4% higher (<i>p</i> = 0.021), and Cl<sub>R</sub> of TMAO was 22.6% lower (<i>p</i> = 0.025) after treatment with dapagliflozin compared to placebo. For empagliflozin, a similar trend was observed, but did not reach statistical significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Treatment with an SGLT-2 inhibitor was associated with a modest increase in plasma concentration of TMAO. Together with data from a previous trial, the present findings suggest a possible class effect of SGLT-2 inhibitors. Whether this effect impacts the overall clinical benefits of SGLT-2 inhibitors needs to be subject to further investigations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>http://www.clinicaltrials.gov: NCT02471963 (registered 15th June 2015, retrospectively registered) and NCT02383238</p>\u0000","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70318","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149084071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Oral Non-Statin Lipid-Lowering Therapies in Dyslipidaemia: A Systematic Review and Network Meta-Analysis","authors":"Tamer Hodrob,&nbsp;Reem J. Saad,&nbsp;Aya Hamdy,&nbsp;Mariam Saleh Alheneedy,&nbsp;Ahmed Mohamed Shehata Abdelfattah Elsayed,&nbsp;Elsaghir Ghazy,&nbsp;Hazem Ayesh","doi":"10.1002/edm2.70353","DOIUrl":"https://doi.org/10.1002/edm2.70353","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Dyslipidaemia remains a major contributor to atherosclerotic cardiovascular disease (ASCVD), and many patients fail to achieve recommended low-density lipoprotein cholesterol (LDL-C) targets despite statin therapy or are unable to tolerate statins. Oral non-statin therapies have emerged as important alternatives; however, their comparative efficacy and safety remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically searched PubMed, Embase, Web of Science, and Cochrane Central up to December 2025 for clinical trials evaluating these medications in adults with dyslipidaemia. Primary outcomes were percent and absolute changes in LDL-C, while secondary outcomes included other lipid parameters and safety profile. A frequentist random-effects network meta-analysis was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-three trials comprising 17,021 participants were included. Combination therapies showed the greatest efficacy, with obicetrapib 10 mg plus ezetimibe 10 mg achieving the largest reduction in percent LDL-C (−49.15%; 95% CI: −59.42 to −38.89), followed by bempedoic acid plus ezetimibe (−36.90%; 95% CI: −44.65 to −29.15). Obicetrapib also showed substantial improvements in HDL-C and ApoB. Safety outcomes were generally reassuring, with no significant increase in serious adverse events, myalgia, headache, or elevated liver enzymes; however, treatment discontinuation was higher with bempedoic acid 180 mg and colesevelam 3.75 g. The certainty of evidence was low to very low for many efficacy outcomes, primarily because of heterogeneity and imprecision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Oral non-statin combination therapies, particularly obicetrapib plus ezetimibe and bempedoic acid plus ezetimibe, provide the most effective LDL-C lowering and are valuable for patients with statin intolerance or residual risk. Ezetimibe remains a well-tolerated option. Long-term cardiovascular outcome trials are needed to confirm clinical benefit.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70353","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149084072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Landscape and Thematic Evolution of Selective GLP-1 Receptor Agonists and GLP-1–Based Multi-Receptor Agonists in Type 2 Diabetes Mellitus: A Bibliometric Analysis","authors":"Yanbing Wang,&nbsp;Zhanru Liu,&nbsp;Shifeng Wang,&nbsp;Cuiyan Lv,&nbsp;Hesham R. El-Seedi,&nbsp;Shaden A. M. Khalifa,&nbsp;Haiyan Wang","doi":"10.1002/edm2.70351","DOIUrl":"https://doi.org/10.1002/edm2.70351","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To characterize the global development, collaboration structure, publication landscape, citation influence and thematic evolution of research on selective GLP-1 receptor agonists and GLP-1–based multi-receptor agonists in T2DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A bibliometric analysis was conducted on 3736 original articles published between 2004 and 2025 and retrieved from the Web of Science Core Collection. Publication trends, research contributions, collaboration networks, citation impact and thematic evolution were evaluated using complementary bibliometric indicators and network analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Annual publication output increased substantially. Selective-only studies remained the cumulative core of the evidence base, while mixed/comparative and multi-receptor-only studies expanded rapidly in recent years. The United States led in research output and international connectivity, and Novo Nordisk and Eli Lilly were the most prominent institutional contributors based on author affiliation analysis. Diabetes, Obesity and Metabolism was the leading source journal. Research output was highly concentrated across countries but more widely distributed across institutions and authors. Thematic emphasis shifted from incretin biology and glycemic efficacy toward cardiovascular and kidney outcomes, obesity, integrated treatment strategies and real-world evidence. Major trials, particularly LEADER and REWIND, and ADA/EASD consensus statements exerted strong citation influence. Sensitivity analysis supported the overall robustness of the principal findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Research on GLP-1–based agonists in T2DM has expanded rapidly and shifted toward an integrated cardiovascular–kidney–metabolic framework. Studies of selective GLP-1RAs remain central to the literature, while studies of newer GLP-1–based multi-receptor agonists are contributing to its diversification. Evidence remains comparatively less developed for longer-term outcomes of emerging agents, treatment sustainability in routine care, patient experience and diverse populations and settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70351","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149084070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Tirzepatide Versus Dulaglutide in Type 2 Diabetes With or Without Established Atherosclerotic Cardiovascular Disease: A Network Meta-Analysis of Randomized Clinical Trials.","authors":"Ahmed W Hageen, Ahmed Farid Gadelmawla, Ahmad Omar Saleh, Salma Bahnasy, Safir Eladawi, Moatasem Abdelaziz, Khalil Iyad, Ahmed Hamdy Kandil, Karim Zinhom, Mohamed Reyad Mohamed, Hind Abdulhay, Mustafa Turkman, Basel Abdelazeem, Gregg C Fonarow","doi":"10.1002/edm2.70313","DOIUrl":"10.1002/edm2.70313","url":null,"abstract":"<p><strong>Background and aim: </strong>This network meta-analysis addresses the limited dose-specific comparative evidence by evaluating different doses of tirzepatide (TZP) versus dulaglutide (DULA) for glycemic control, weight loss, and safety in type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>Following PRISMA and Cochrane guidance, we searched major databases for RCTs comparing TZP and DULA in adults with T2DM. Efficacy outcomes included body weight change (Weeks 12 and 16) and mean HbA1c change (Weeks 12 and 24). Safety outcomes included mortality, cardiovascular events, and adverse events (AEs). SUCRA ranking was used and analysis performed in RStudio (v4.5.1).</p><p><strong>Results: </strong>Four RCTs comprising 14,348 participants contributed to a seven-node network. However, Nicholls et al. 2025 had the majority of sample size (n = 13,165). TZP 15 mg achieved the greatest reduction in body weight at Week 16 (mean difference [MD] vs. TZP 5 mg: -2.68 kg; 95% CI -4.98 to -0.38), while TZP 1 mg (MD: 4.39 kg; 95% CI 1.28 to 7.51) and DULA 0.75 mg (MD: 3.10 kg; 95% CI 0.25 to 5.96) were associated with smaller reductions relative to TZP 5 mg. TZP 15 mg also produced the largest HbA1c reduction at Week 24 (MD vs. TZP 5 mg: -0.40%; 95% CI -0.62 to -0.19), compared with TZP 10 mg (MD: -0.23%; 95% CI -0.44 to -0.02) and DULA 1.5 mg (MD: 0.67%; 95% CI 0.25 to 1.09). No significant differences were observed between treatments for all-cause mortality or major cardiovascular events. Gastrointestinal AEs were more frequent with higher TZP doses, especially TZP 15 mg vs. TZP 5 mg for nausea, while serious AEs and severe hypoglycemia were similar across doses.</p><p><strong>Conclusion: </strong>Higher TZP doses potentially improve efficacy, while lower TZP/DULA doses enhance tolerability, supporting individualized T2DM care. However, these findings should be interpreted cautiously because several comparisons are indirect, many participants had not reached their maintenance dose, several safety outcomes were based on limited event counts, and significant inconsistency was observed for early body-weight outcomes.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70313"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on Pituitary Tumour Apoplexy as Cause of Death of Simonetta Vespucci.","authors":"Alexis Demas","doi":"10.1002/edm2.70334","DOIUrl":"10.1002/edm2.70334","url":null,"abstract":"","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70334"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Aldosteronism Subtype Diagnosis: Adrenal Venous Sampling vs. CXCR4 PET CT.","authors":"Shengzhuo Liu, Yifan Zhang, Xiaoyang Liu, Huijun Zhou, Sikui Shen, Ning Yin, Yuchun Zhu","doi":"10.1002/edm2.70254","DOIUrl":"10.1002/edm2.70254","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the clinical value of adrenal venous sampling (AVS) and CXCR4-directed ⁶⁸Ga-pentixafor PET/CT in the subtype diagnosis of primary aldosteronism (PA), with postsurgical blood pressure control and biochemical cure as primary endpoints, and to compare the accuracy and practicability of the two methods.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted in PA patients undergoing unilateral adrenalectomy at West China Hospital between February 2023 and June 2025. Patients were divided into the AVS and CXCR4 imaging groups. The primary outcome was the clinical and biochemical success rate according to the Primary Aldosteronism Surgical Outcome (PASO) criteria. In the subgroup with both procedures, AVS was considered the reference standard to assess the diagnostic efficacy of CXCR4.</p><p><strong>Results: </strong>A total of 160 patients completed the trial. According to the PASO criteria, the total biochemical success rate was 93.1%, among which the complete biochemical success rate in the AVS group was 84.1%, and in the CXCR4 group it was 93.1% (p = 0.091); the total clinical success rate was 82.5%, with a complete clinical success rate of 40.9% in the AVS group and 30.3% in the CXCR4 group (p = 0.412). There were no statistically significant differences between the two groups. In 16 patients with both examinations, CXCR4 showed a sensitivity of 70.0%, specificity of 83.3%, accuracy of 75.0%, and moderate agreement with AVS.</p><p><strong>Conclusion: </strong>CXCR4 showed no statistical difference from AVS in diagnostic and prognostic outcomes in this study. However, discordance in multinodular disease indicates that molecular imaging cannot fully reflect the heterogeneity of aldosterone secretion. This finding requires verification in a larger cohort.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70254"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Oral Dextrose Gel for Neonatal Hypoglycaemia: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials With 4368 Patients.","authors":"Rowa Tareq Al-Enezi, Fatmah A Alshebeeb, Julia Rose Panikulam, Dana B AlKhaldi, Rawan B Almutairi, Riyam Tareq Alenezi, Anwar M Aljassar, Raghad B Aldosari, Fajer Ali Alkandari, Amnah A Dashti, Khadeja A Aldhahi, Hamza A Abdul-Hafez, Abdullah M Alharran","doi":"10.1002/edm2.70327","DOIUrl":"10.1002/edm2.70327","url":null,"abstract":"<p><strong>Background: </strong>Neonatal hypoglycaemia is a common metabolic disorder affecting up to 15% of healthy neonates and a higher proportion of at-risk infants. Oral 40% dextrose gel has emerged as a promising, low-cost intervention, but recent evidence remains inconsistent. This updated meta-analysis evaluated the efficacy of 40% oral dextrose gel for preventing and treating neonatal hypoglycaemia.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, Web of Science, Scopus and the Cochrane Library from inception to March 2026 for randomized controlled trials evaluating 40% oral dextrose gel in neonates at risk for or with confirmed hypoglycaemia. The primary outcome was hypoglycaemia. We used R software (version 4.5.0) for the analysis.</p><p><strong>Results: </strong>Eight RCTs comprising 4368 neonates were included. Dextrose gel did not significantly reduce hypoglycaemia, treatment success, recurrent hypoglycaemia, neonatal intensive care unit (NICU) admission, breastfeeding at discharge or formula feeding. Sensitivity analysis excluding Harding et al. (2021) for NICU admission yielded a statistically significant 24% reduction. Trim-and-fill adjustment for recurrent hypoglycaemia and formula feeding did not alter conclusions.</p><p><strong>Conclusions: </strong>Current evidence did not demonstrate a statistically significant reduction in overall hypoglycaemia, treatment failure, recurrent hypoglycaemia, NICU admission or breastfeeding interruption after administration of oral 40% dextrose compared with control. While safe and low-cost, current evidence does not support routine use as a standalone intervention. Heterogeneity across protocols and populations warrants standardization in future trials.</p><p><strong>Trial registration: </strong>PROSPERO registration number: CRD420261368171.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70327"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liraglutide in Adults With Obesity: A Multicentre, Single-Arm, Post-Marketing Surveillance Study in Taiwan.","authors":"Shih-Te Tu, Chiao-Fan Chiu, Chu-Kuang Chou, Hai-Hua Chuang, Shu-Wei Hu, Wen-Ching Ko, Chun-Ying Lee, Wen-Yuan Lin, Yen-Jen Sung, Thing-Fong Tzeng, Weu Wang, Hsiang-Fan Wu, Chun-Yan Yeung, Bill Chen, Chet Joe Sim, Kuo-Chin Huang","doi":"10.1002/edm2.70333","DOIUrl":"10.1002/edm2.70333","url":null,"abstract":"<p><strong>Introduction: </strong>This prospective study (NCT06283641) was the first real-world, multicentre, post-marketing surveillance of GLP-1 receptor agonist liraglutide as an adjunct for weight management in adults with obesity in Taiwan.</p><p><strong>Methods: </strong>Data were collected from 14 sites at baseline, week 13 and week 26 (February 2024-January 2025). Safety and effectiveness outcomes, including adverse event (AE) incidence proportions (IPs) and body weight (BW) change, were investigated.</p><p><strong>Results: </strong>Among 259 adults, 61.0% were female (mean ± SD age 42.6 ± 11.3 years, BW 90.4 ± 17.6 kg, BMI 33.0 ± 4.7 kg/m²). Dyslipidaemia (38.2%), hypertension (26.3%), and diabetes (21.2%) were common. Mean daily and maximum doses were 1.4 ± 0.5 and 1.8 ± 0.7 mg/day, respectively. Overall IP of AEs was 11.2%; 90.9% of events were mild. General/injection-site and gastrointestinal events were most frequent. Medication cost (49.0%) was the predominant factor for dose non-escalation. At weeks 13 and 26, mean BW loss was -5.7 ± 3.5 and -8.5 ± 5.7 kg (both p < 0.0001; ≥ 5% BW loss in 58.4% and 76.7%) and mean systolic blood pressure decrease was 9.0 ± 16.7 and 10.4 ± 18.9 mmHg, respectively.</p><p><strong>Conclusion: </strong>Liraglutide at < 3.0 mg/day was well-tolerated, with BW reduction observed over 26 weeks in Taiwanese adults. Medication cost is a barrier to long-term obesity management and a significant consideration for health policies in Taiwan.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70333"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role and Mechanism of Incretins in Gynaecologic Diseases.","authors":"Jiayu Yan, Minyue Cao, Yan Ding, Yiqin Zhang, Yihan Sun, Genyi Jiang, Yanli Zhang, Luyao Kang, Xue Zhou, Jing Luo, Bilan Li","doi":"10.1002/edm2.70340","DOIUrl":"https://doi.org/10.1002/edm2.70340","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a major global public health concern closely linked to the development and progression of various gynaecological disorders, particularly polycystic ovary syndrome (PCOS) and endometrial cancer. Incretins, a group of gut-derived hormones primarily including glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), are widely recognised for their roles in glycemic control and insulin secretion. Accumulating evidence reveals that GLP-1 and GIP also participate in modulating inflammation, autophagy, immune response and gut-brain communication through multiple signalling pathways, thereby playing important roles in female reproductive disorders. This review provides a comprehensive overview of the mechanisms and therapeutic potential of incretins in gynaecological conditions.</p><p><strong>Methods: </strong>We performed a comprehensive literature search across PubMed, Web of Science and Embase, covering studies published from January 1995 to July 2026. Search terms combined incretin-related keywords (GLP-1, GIP, GLP-1 receptor agonists) with gynaecological disease terms (polycystic ovary syndrome, endometriosis, endometrial cancer, ovarian cancer, intrauterine adhesion). We primarily included original research studies and authoritative reviews, and excluded meeting abstracts, case reports and non-English literature.</p><p><strong>Results: </strong>GLP-1 receptor agonists (GLP-1 RAs) exert multi-faceted benefits in PCOS, endometriosis, intrauterine adhesions and gynaecologic cancers through cAMP/PKA, PI3K and AMPK signalling pathways. Special emphasis is placed on the multi-faceted benefits of GLP-1 RAs, while evidence supporting GIP-based therapies in gynaecology remains relatively limited and largely preclinical. The current status of clinical application, safety considerations and future directions are further discussed.</p><p><strong>Conclusion: </strong>Incretin-based therapies offer novel approaches for metabolic and oncological gynaecological diseases, with significant translational value. Large-scale clinical studies and deeper mechanistic exploration are warranted to realise their full therapeutic potential.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70340"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Visceral Adiposity Index and Metabolic Syndrome and Its Components: Evidence From the PERSIAN Guilan Cohort Study.","authors":"Negin Letafatkar, Ehsan Amini-Salehi, Seyyed Mohammad Hashemi, Soheil Hassanipour, Maryam Jafari, Saeed Ghaffari, Farahnaz Joukar, Fariborz Mansour-Ghanaei","doi":"10.1002/edm2.70341","DOIUrl":"10.1002/edm2.70341","url":null,"abstract":"<p><strong>Background: </strong>The Visceral Adiposity Index (VAI) is proposed as a surrogate marker of visceral adipose dysfunction. We evaluated its association with metabolic syndrome (MetS) and its components in a large Iranian population.</p><p><strong>Methods: </strong>This cross-sectional study included 10,520 participants from the PERSIAN Guilan Cohort Study. VAI was calculated using sex-specific equations. MetS was defined according to Adult Treatment Panel III criteria. Multivariable logistic regression assessed associations between VAI and MetS, while ROC analysis evaluated the discriminatory ability of VAI for identifying MetS.</p><p><strong>Results: </strong>MetS was present in 40.7% of participants (24.5% of men, 54.7% of women). VAI was significantly higher in individuals with MetS than in those without [3.31 (IQR 2.40-4.69) vs. 1.64 (1.14-2.32); p < 0.01]. In the fully adjusted model, each one-unit increase in VAI was associated with higher odds of MetS in the overall population (OR = 2.41; 95% CI: 2.31-2.51), with a stronger association in women than in men (OR = 3.20 vs. 1.92; p for interaction < 0.001). VAI showed good discriminatory ability for identifying MetS in the total population (AUC = 0.84; 95% CI: 0.83-0.84), men (AUC = 0.83; 95% CI: 0.81-0.84), and women (AUC = 0.84; 95% CI: 0.83-0.85). Optimal VAI cut-off values were 2.42 in the overall population, 2.08 in men and 2.69 among women. VAI was most strongly associated with triglycerides and HDL-C, while significant associations were also observed with elevated fasting plasma glucose (FPG) and blood pressure (BP).</p><p><strong>Conclusion: </strong>VAI was strongly associated with the presence of MetS in this large Iranian population and demonstrated good discriminatory ability. Although part of this association may reflect shared components between VAI and the MetS definition, its significant associations with elevated FPG and BP suggest a broader relationship with cardiometabolic risk. Prospective studies and external validation are warranted before clinical application.</p>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 5","pages":"e70341"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}